Category Archives: News

coyote

A Year in the Life

I guess this makes me a cancer survivor now?  Shouldn’t that come with a medal or a cape or some sort of frame-worthy certificate, at the very least?

In case that’s too oblique, the PET scan results were good and there is no indication of cancer although there are a couple of caveats.  I’ll get to all that in a moment.

For the last several days… hell, for the last several months… I have been preparing myself for bad news.  As I’ve said in previous posts here, I don’t feel all that great most of the time and a lot of what is happening was troubling concerning my recent medical history.  Abdominal pain, weight loss, nausea, lack of energy, pain near a cyst on my back… none of these are good things when one has had cancer, especially the type of cancer I had.  It’s like when Wile E. Coyote is in hot pursuit of the Road Runner and they pass a sign that says “Bridge Out Ahead.”  You just know that the Road Runner will sail on across the chasm unaffected by silly things like gravity while poor old Wile E. will get about halfway out and then suddenly his body will drop and his neck will stretch out really long and then his head will drop and it’s dust clouds and stars at the bottom of the ravine.

Just to be clear, in this particular pop culture reference I am the coyote, only no one has ever referred to me as a super genius.

So yeah, my brain has been filled with doom and gloom.  I was even practicing how I was going to tell people that I was dying. That sounds a little sick, I guess, but as many of you know words are very important to me and when you have to impart news like that, choosing the right ones to use is critical.  You can’t just blurt out, “I’m dying.”  That would suck for everyone involved.  Besides, it’s inelegant and lacks a certain je ne sais quoi.  I don’t know what je ne sais quoi means, but I’m sure it lacks it.

That last sentence was totally meta, by the way.

Preparing for the worst and being surprised when it doesn’t happen has been my modus operandi for most of my life.  Some people might call that pessimism but I prefer to call it situational awareness.  I don’t want bad things to happen and understand that most of the time they don’t.  I mean, after all, the list of shit that could go wrong from the moment you get out of bed is epic and I have never been shot, stabbed, electrocuted, attacked by killer bees, mauled by a rabid ferret, drowned in the bathtub, hit by falling space debris, pinned under earthquake rubble, or run down by an ’87 Oldsmobile driven by an elderly woman who should’ve turned in her license ten years ago, to name a few things that spring to mind.  I don’t expect any of that stuff to happen but if it does, I would much rather be the person that knew it was a possibility than the dumbass laying in a hospital bed who says, “I thought the old lady was gonna stop!  I was in the crosswalk!!”

My problem is (and always has been) that while I am prepared for the worst, I’m not always prepared for the best.  Take now, as an example.  I don’t know what to do with “there are no indications of cancer.”  It’s good news; I get that.  Break out the champagne type of news.  Logically, I know I should be thrilled and yet here I am kind of… hmmm… what’s the word I’m looking for?  Perplexed, perhaps.  Perplexed and a little flummoxed.  I am at sixes and sevens as the Brits like to say.

I don’t know what to do with “there are no indications of cancer.”  I don’t know how to process that.  It just doesn’t compute.

Part of it, I think, is because of the aforementioned not feeling good.  I didn’t want cancer to be the reason for all that and as I said in my last post wasn’t actually expecting it to be cancer, but at least that would have been an explanation.  I can deal with anything as long as I know what it is but ambiguity and a lack of information makes me insane.  To be clear, I’m NOT saying that I’m disappointed that it’s not cancer causing all of this stuff, but I am disappointed that I still don’t know what is.

Another part of it, I posit (yes, thesaurus.com is getting a workout today), is that I have been so wrapped up in cancer that I don’t know what I look like without it.  It’s been almost exactly a year.  I had my endoscopy on June 1st of 2012 and got the confirmation of the cancer diagnosis on June 13th.  A year of dealing with the having it and getting it cut out and recovering from the having it cut out and the maybe having it again and the on and on and on.  No matter how you deal with it, cancer, I have learned, is not lower case.  It is all-caps and strong punctuation: CANCER!!!  No matter what people say and how hard people try for it not to be, it is, in some ways, defining.  You are a person with cancer; it is quite literally a part of you.  And even though it’s a part of you that you don’t want, not having it anymore is strange.  It’s a good strange, I guess, but strange nevertheless.

While I try to figure out how to process all this, we should talk about the caveats.  First, I’ve got this cyst on my back and that needs to be biopsied just to make sure.  That will happen with a small surgical procedure that will apparently totally ruin my vow to not let people cut me open anymore.  Second, the PET scan did show “nodular thickening and hypermetabolic activity” in the gastric area where the original cancer and subsequent surgery happened.  Much like the stuff you see on Fox News, this is most likely inflammatory in nature and should be ignored but since the “possibility of carcinoma cannot be excluded” (taken from the report) they need to go have a little look-see.  This means another endoscopy, which will bring the whole thing full-circle.

So some more tests and waiting rooms and medical bills but for the most part this should mean that I am done with all of this cancer… sorry, CANCER!!!… stuff.

Okay… now what do I do?

(that’s rhetorical – please don’t send me suggestions)

Act 2

It’s been awhile since I have posted.  There have been reasons both good and bad for that.  Good in that there was nothing particularly noteworthy to talk about other than my ongoing, thrice-daily cage match with food in which I tried to find something to eat that didn’t physically repulse me or twist me in pain as I tried to digest it.  Bad in that I felt that talking about it too much would be seen as whiny and ungrateful, which was probably unfair to all of us.

But I have returned, now, because so has the cancer.  Actually it was never really gone in the first place, but that is a distinction probably left to the academics at this point.  I’ll let you chew on that one for a moment while we take a flashback.

It’s been a little over five months since I last wrote about what was going on with me.  I had just gotten the blasted feeding tube (aka: bane of my existence) removed and was cautiously optimistic that things were going to improve.  And they did, to a point.  I was able to eat more and more often.  The pain I experienced after eating diminished in intensity and frequency.  My energy level increased, I was able to go back to work, my breathing issues improved, and I was able to sleep, finally.

But then things kind of plateaued and I stopped getting better.  It seemed as if I just sort of got stuck, with my digestive system a million times better than it was but nowhere near normal.  Dramatic evidence of this was seen on the scale every day.  When I went into the hospital, I weighed (an admittedly too heavy) 236 pounds, which I blame on my oncologist (aka: Dr. Wile E. Coyote Super Genius) who told me to gain weight before the surgery because I would lose a lot afterward.  When I came out of the hospital, I weighed 205 pounds, a loss of more than 30 pounds for those of you unable to do math quickly in your head.  Don’t feel bad, I had to use a calculator to figure it out.

That was September.  By October it was 40 pounds.  In November it was 50 pounds.  By December I stepped on the scale and saw the number 173 come up, a weight I had not weighed since junior high (I was really fat when I was a kid).  I had lost a mind-boggling 63 pounds, a full quarter of my pre-surgery body weight.

My life started to revolve around my scale, but in a totally different way than I was used to.  For most of my 46 years on the planet, I would step on the scale in the morning and pray that I had lost a pound or two.  Now I was praying that I hadn’t.  Most days I had.

And food.  Food became the enemy.  I used to love eating.  As we have discussed here, I was an emotional eater.  I ate when I was happy, I ate when I was sad, I ate when I was angry, I ate when I was bored.  I ate to help me fall asleep, I ate to help me wake up, I ate to keep me distracted from whatever it was that was bothering me, I ate to prove points (to myself and others).  I ate before sex to build up my stamina and ate after sex the way some people smoke cigarettes.  I’ve eaten during sex, but that’s probably a story for another time.  The point is, I ate.  But then I didn’t and I couldn’t and often the thought of it made me nauseous and I had to sometimes almost physically force myself to put another bite in my mouth.

My surgeon, Dr. Frenchy, put me on a narcotic that was designed to even things out digestively speaking and it did.  The pain diminished even more, I was spending less time in the bathroom, and most importantly I was able to eat without wanting to kill myself every time.  The trouble was that the narcotic nature of it turned me into a bit of a zombie and the previous bad stuff was replaced by new bad stuff, like recurring bouts of nausea, which would often start while I was sleeping and get so bad they would wake me up.  Fun.  It did arrest the weight loss and I didn’t go below 173.  As I write this I am all the way up to 175!  Woohoo!

I complained to whatever doctor would listen to me and was repeatedly told that this was just part of the recovery – they had basically rewired my entire digestive system and that takes time to sort itself out.

In January I started experiencing new pains, some around my incisions but also some in places that were approximately where my pancreas and liver were.   That scared the doctors into moving up the normal 6-month follow-up and the tests started.

A set of blood tests showed that my liver function was off, along with some other anomalies that weren’t there just a couple of months earlier.  Then came the CAT scans, which came back “indeterminate.”  Finally, another stab at radioactivity (still no spider webs) during a PET scan, the results of which Dr. Wile E. Coyote Super Genius delivered today.

There is a spot on a lymph node near my liver.  It was there all along – back when I had the first PET scan and the surgery and the biopsies and everything – it just was so small it couldn’t be seen.  Now it’s there, glowing like a little 1.6 cm point of light.

Now, the odds that this spot is the only spot that is hanging around my abdomen are roughly the same as rolling a hard 8 in craps or of me winning this season of American Idol, but that’s all the PET scan could see and therefore that is the theory we are going to operate under for now.

And speaking of operating, that is the next step.  I am going to undergo a laparoscopy next Thursday, March 7, at which time Dr. Frenchy will go in, take a little stroll through my guts, and see if he can see anything bad other than that one mischievous little lymph node.

If he can’t, he will remove the lymph node and take biopsies of the surrounding nodes and tissue.  Then I will have to undergo an unspecified amount of chemotherapy and radiation in an effort to burn out anything that can’t be seen by the PET scan or the surgeon’s eyes.  You know, like the spot that couldn’t be seen 6 months ago.

The survival rate through all this is a bit better than 50% but not much better.  Having said that, those are better odds than you usually get at the craps table so I’m willing to roll that particular set of dice.

However.  But.  Although.

If I don’t roll the hard 8 and Dr. Frenchy does see more spots, he will remove what he can, quietly zip me back up, and that, as they say, will be that.

There is no coming back from that and, according to Dr. Wile E. Coyote Super Genius, I would probably have 3 to 6 months to live if I choose not to have life-extending treatment (ie: chemo and radiation) and maybe as much as a year if I choose to have it, but it probably won’t be a very fun year.

After he told me all this, he hugged me.  For future reference, when a doctor, especially an oncologist, hugs you, it’s not good.  I mean, it’s good and lovely and exactly what I needed at that moment, but in the grand scheme of things, it probably means something bad is happening, has happened, and/or is about to happen.  Get your affairs in order bad.  Drunken weekend bad.  Eat everything in sight bad, except I can’t do that because of my fucking digestive system.  Whatever.

I’m only 10 or so hours into this new reality so it isn’t actually real yet.  I’m not sure what I’m feeling other than generally freaked out and more than a little peeved.  But Mary taught me a lot about dealing with cancer and most of it boils down this: you deal with it. I could go curl up into a little ball in the corner but I wouldn’t be able to reach the refrigerator or see the TV from there, so really, what’s the point of that.  Besides I haven’t vacuumed in a couple of weeks and there are probably dust bunnies and maybe a spider in the corner so, no.

I know you will all be concerned and supportive and send me good thoughts and happy vibes and well-wishes and prayers and all that good stuff and just know that I deeply, deeply appreciate it even if outwardly I, in my typical fashion, try to brush everything off as no big deal.  I get this is a big deal, I really do.  You know why I know?  My boss, who is a lovely man but not someone that you would normally associate with the concept of hugging, hugged me after I told him today.  First my oncologist and then my boss.  As it was happening I thought, “Geez, what am I, dying?”  And then I thought, “Ohhhhh.”

In other words, I’m not fine, but I will be.  I’m going to take the day tomorrow to sulk and feel sorry for myself and then on Friday I’ll get on with it.  What other choice do I have?  I’m not saying there won’t be rending of garments and gnashing of teeth at various times over the next however long this all takes but in between those moments I’ll just be pluckily plugging along like we do.

When Mary’s cancer returned we called it, variously, “Cancer II: Cancer Takes Manhattan” and “Cancer 2: Electric Boogaloo.”  When it came back again we named it “Cancer: The Extended Dance Remix.”  Since my cancer was never really gone, I won’t call this a sequel.  Instead, I’ll simply refer to it as another scene; a new act in the little drama about how food is still trying to kill me.

Fade in…

And action!

August 17th: On This Day in History

  • 1786: Davy Crocket is born
  • 1807: The first commercial steamboat sailed in New York
  • 1893: Mae West is born
  • 1907: Pike’s Place Market opens in Seattle
  • 1915: A category 4 hurricane hits Galveston, Texas
  • 1943: Robert De Niro is born
  • 1953: The first meeting of Narcotic’s Anonymous is held
  • 1958: Belinda Carlisle is born
  • 1960: Sean Penn is born
  • 1969: Hurricane Camille hits the Mississippi coast
  • 1979: Vivian Vance dies
  • 1980: Infant Araria Chamberlin disappears in Australia, taken by a dingo
  • 1982: The first compact discs are released to the public in Germany
  • 1983: Ira Gershwin dies
  • 1998: President Clinton admits that he had an affair with Monica Lewinsky
  • 2008: Michael Phelps becomes the 1st to win 8 gold medals in one Olympics
  • 2012: Rick has his surgery

I don’t know if my thing will make Wikipedia, but I think it should.

Asterisk II: Revenge of the Asterisk

The short version: it’s most likely stage 1B but there is some activity in the lymph nodes near the tumor that while not specifically cancerous are enough to put an asterisk on the 1B.

If you haven’t read the post about the different stages of esophageal cancer, you may want to do that but the short version of that is: stage 1 is bad but fixable; everything else is just plain old bad.

Now, the longer version… It’s been an interesting day.  I was wide awake by 6am and spent the next nine hours before I was to go in and get the results of my PET scan going back and forth between a shrugging Zen like state and almost paralyzing anxiety.  On the one hand, there is absolutely nothing I could do to influence the results so getting stressed out about it seemed like a waste of energy but on the other hand, “AIIIGGHHH!!!!!!! I HAVE CANCER!!!!!! I’M GOING TO DIE!!!!!!!!!!!!!!”

So yeah, it was a bit of a roller coaster day emotionally.  Luckily I had lots of work to do but unfortunately a lot of it involved documenting my job so that someone else could do it, either temporarily or…. “AIIGH!!!!”

I went in to see Dr. Wile E. Coyote, Super Genius and was ushered in almost immediately even though I was a solid 25 minutes early for my appointment.  That concerned me.  Then I got even more concerned when I overheard the nurse calling the scanning place to ask them if they had the results of the tests in yet.  As much as I was worried about what the results were going to be (“AAIIGH!”), I absolutely, positively could not take another day (another hour, another minute) of the waiting so the idea that they hadn’t gotten the report was anxiety provoking for a completely different reason.

But then Dr. Wile E. Coyote, Super Genius came in and handed me a copy of the report.  Before he could speak I stopped him.  I pulled a bag of mint M&M’s out of my pocket and said, “Whatever it is you’re about to tell me, I believe it will require chocolate.”  He appreciated that and asked for some.  Have I mentioned how much I like this doctor?

Then he cut to the chase with a simple statement:  “I have good news.”

Now, “good” in this case is decidedly relative, which is to say, I have cancer most certainly but there is “no evidence of metastatic disease and no metabolically active lymph nodes.”  What that means is that the cancer is stage 1B, invasive to the lining of the esophagus but it has gone no further*.

Yes, there’s an asterisk, but a different one than the first one.

Many of the lymph nodes near the tumor are “reactive,” which means they are pissed off about something.  What they are pissed off about is unknown.  It could be a result of the infection I had in my eye and mouth last week or it could be leftover from the cold I had a couple of weeks ago or it could be some other simple infection or a million other innocuous things.

It could also be that the cancer has started to invade the lymph nodes but hasn’t gained enough territory to show up as “metabolically active” (aka: cancer) on the PET scan.  The fact that the lymph nodes that are reactive are the ones nearest to the tumor and that the ones in other places (for instance closer to the infection in my head) are fine is enough to give one pause, but pause for only a minute because now it’s time to get serious about this crap.

Surgery is officially a “go” and there will be no chemotherapy or radiation beforehand.  I am meeting with the cardiothoracic surgeon next Tuesday the 31st and then he and Dr. Frenchy will coordinate schedules and figure out when they can tag team to Julienne my innards.  I’m guessing that the earliest this will happen is probably the week of August 13th.

When Dr. Frenchy takes out the offending portion of the esophagus and stomach, he will also remove those asterisk inducing lymph nodes nearby and they will be biopsied.  If there is some cancerous activity in them, then it’ll get more interesting again with talk of chemo and radiation but we’ll burn that bridge when we get to it.

It’s kind of ridiculous that I am relieved by the news today.  I mean, after all, I still have to go have portions of my body ripped out in a really awful, dangerous, and life-changing surgery but compared to the alternative (“AIIIGH!”), it seems like less of a big deal than it did when I first got the news.

Now, I’m certain that between now and the surgery, my “relief” will give way to “AIIGH!” again but for now I’m going to take whatever ground I can capture in this particular land war.

“You fell victim to one of the classic blunders. The most famous is ‘Never get involved in a land war in Asia,’ but only slightly less well known is this: ‘Never go in against a Sicilian when death is on the line.’”
Just popped into my head. Had to be done.

One more note which gives more evidence as to why I like Dr. Wile E Coyote, Super Genius so much.  At the end of our meeting he shook my hand firmly and said, “Congratulations” and then told me about this chocolate drink at Starbucks he was addicted to.  I said I didn’t need to know about something else chocolate – I consume too much of it as it is.

“No, you have to gain weight before your surgery!” he said.

“Really,” I said looking down at myself, “I think I need to lose weight.”

“You’re going to lose weight after the surgery,” he said, “Before, go crazy.”

So I stopped on the way home and got a double cheeseburger and fries with ranch dressing from Rick’s Drive In in Silver Lake.  I’m going to check out the Starbucks chocolate drink thing tomorrow.

My doctor told me to!